title: Immediate renal Doppler ultrasonography findings (<24 h) and its association with graft survival.
abstract: OBJECTIVE
  Renal Doppler ultrasonography (DUS) is the gold-standard image test for follow-up after renal transplantation, it is potentially useful to detect renal disease and it could be related with long-term survival. We evaluate whether renal graft survival can be predicted by immediate renal Doppler ultrasonography (IRDUS), defined as ultrasonography carried out in the first 24 h post-surgery.
  
  
  METHODS
  Immediate renal DUS findings (resistance index, hydronephrosis, fluid collection, bruises, and vascularization abnormalities) and their association with graft survival were analyzed in a retrospective observational study of 343 renal allografts. Renal transplantation was done using a standard technique, and DUS was performed 24 h post-transplantation. The association of variables with graft survival was evaluated by Cox univariate and multivariate proportional hazards analysis. Kaplan-Meier survival analysis and the log-rank test were used to examine graft survival.
  
  
  RESULTS
  The follow-up median was 85 months. On IRDUS, 137 patients (39.9%) had abnormal findings. The best RI cutpoint for the prediction of graft survival was 0.7; therefore, we defined two different groups: RI ≤ 0.7 (n = 247) versus RI > 0.7 (n = 96). Univariate analysis revealed that graft survival was significantly lower in patients with RI > 0.7 (P ≤ 0.001), vascularization abnormalities (P ≤ 0.001) or bruises (P = 0.026). In multivariate analysis, the only factors independently associated with graft survival were RI (odds ratio 2.4; 95% CI 1.4-4.1) and vascularization abnormalities (odds ratio 2.7; 95% CI 1.1-6.5).
  
  
  CONCLUSIONS
  IRDUS can be useful, besides being highly useful in the diagnosis of graft primary dysfunction in the transplanted patient also yields information that can help to predict long-term graft survival.
authors.affiliation: Department of Urology, University of Navarra Clinic, P.O. Box 4209, 31008, Pamplona, Spain. jfbarba@unav.es
authors.forename: Javier
authors.initials: J
authors.lastname: Barba
authors.forename: Jorge
authors.initials: J
authors.lastname: Rioja
authors.forename: José Enrique
authors.initials: JE
authors.lastname: Robles
authors.forename: Anibal
authors.initials: A
authors.lastname: Rincón
authors.forename: David
authors.initials: D
authors.lastname: Rosell
authors.forename: Juan Javier
authors.initials: JJ
authors.lastname: Zudaire
authors.forename: José María
authors.initials: JM
authors.lastname: Berian
authors.forename: Ignacio
authors.initials: I
authors.lastname: Pascual
authors.forename: Alberto
authors.initials: A
authors.lastname: Benito
authors.forename: Pedro
authors.initials: P
authors.lastname: Errasti
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D018608:Ultrasonography, Doppler / Q000379:methods*